25 March 2020Dear friends, colleagues and associates,During these troubled times, we bring warm greetings of solidarity to all of you from COPASAH - Community of Practitioners on Accountability and Social Action in Health. As practitioners and pro-people advocates all of you are the frontline defenders of marginalised people’s health and wellbeing. Our thoughts are with all of you and with everyone affected by the coronavirus pandemic and/or involved to contain the pandemic.COPASAH is proud to engage and associate with incredible organizations, members and practitioners around the world – civil society organizations, health care providers including frontline health workers, researchers and academia, professional bodies to mention but few – concerned with the wellbeing of the vulnerable communities. We at the COPASAH steering committee and secretariat are inspired and encouraged by all the work of practitioners worldwide in stopping the COVID 19 pandemic, and in ensuring accountability and transparency while carrying on their work.This COVID 19 Pandemic has challenge the capacity of our already weak and fragile health systems worldwide, thus, we need to step up advocacy by calling on the leaders of our countries to step up overall public health resources while dedicating adequate emergency funds, to ensure that health workers have adequate personal protective equipment, and healthcare facilities have functioning infection prevention and control measures including clean running water and handwashing spots everywhere.In advocating for all these, we take a cue from Dr Tedros, Director-General of the World Health Organization (WHO) “calling on everyone to wash their hands in light of COVID-19”. Also the recent UNICEF FACT SHEET on Handwashing on the 13th of March 2020 has revealed that “Handwashing with soap, when done correctly, is critical in the fight against the novel coronavirus disease (COVID-19), but millions of people have no ready access to a place to wash their hands, in total, only 3 out of 5 people worldwide have basic handwashing facilities, according to the latest data.”It also highlighted the following:

40 per cent of the world’s population, or 3 billion people, do not have a handwashing facility with water and soap at home. Nearly three quarters of the people in least developed countries lack basic handwashing facilities at home.

47 per cent of schools lacked a handwashing facility with water and soap affecting 900 million school-age children. Over one third of schools worldwide and half of schools in the least developed countries have no place for children to wash their hands at all.

16 per cent of healthcare facilities, or around 1 in 6, have no hygiene service, meaning they lack hand hygiene facilities where patients receive care, as well as soap and water at toilets.

Coronavirus has exposed the lack of access to basic facilities like water, sanitation to the most vulnerable even to practice basic public health measures of handwashing. Above all, in many countries, the frontline health workers have no adequate preventive equipment such as masks and gloves to protect themselves from infection and prevent the spread of COVID-19.We, as the community of practitioners and defenders of people’s health are deeply concerned about the following at this time of crisis:

Lack of access to protective means for health workers,

Lack of access to protective means (face masks, gloves, sanitizers) for the population in general, but especially for the vulnerable group.

Barriers in access to testing: Several countries are facing lack of tests, thus they use algorithms in order to determine whether one has a right to be referred for testing in public hospital (free of charge). In private health care facilities the tests are often unregulated and are expensive; these need to be effectively regulated

Insufficient mechanisms to protect the financial hardships faced by many people. Some governments have made certain efforts (insufficient though) to compensate for the people working in formal sectors. But measures for vulnerable groups, and those working in informal sector (as most of the marginalized groups work in this sector) either are minimal or do not exist.

Infringement of people’s rights to confidentiality and privacy in some places, due to officials publicising names of COVID 19 patients, contacts or other quarantined persons; this may lead to social ostracism and breakdown of trust in healthcare providers.

In a few places there are certain steps that are taken to protect workers’ rights, for example – pregnant women, parents of minor children, people with certain chronic conditions. However, in most of the places even such measures do not exist. However, even such persons are either forced to work, or have lost their job.

We call upon all the governments to strengthen the public health system and protect the health of the vulnerable and marginalised communities during this crisis. Wherever required, available private healthcare resources should also be brought under control of the public health system, to ensure adequate availability of care to all affected persons during the epidemic. We also call upon all practitioners and civil society defenders of people’s health worldwide, to advocate and create awareness so that our governments and health agencies provide the much needed responses to address the challenges of COVID 19 pandemic. We express our utmost solidarity with the all vulnerable, disadvantaged and otherwise discriminated and excluded communities, as well as frontline healthcare workers involved in dealing with this pandemic.In Solidarity,